Chronic Fatigue Assessment Online

Ongoing fatigue

Fatigue that persists for weeks or months, and is not explained by recent illness, workload, or poor sleep, deserves careful assessment. Many medical conditions can contribute, including iron deficiency, thyroid disorders, vitamin deficiencies, sleep apnoea, depression, and chronic infections.

ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome) is diagnosed clinically after other causes have been considered. Long COVID overlaps with chronic fatigue in many cases. Individualised assessment is important.

How a telehealth GP can help

A NewDoc GP can take a thorough history, order appropriate investigations, address contributing factors, and coordinate care, including referrals to allied health or specialists where indicated. A Chronic Disease Management Plan may be appropriate for some people.

Risk factors and contributors

Chronic fatigue has many possible contributors. Medical conditions that commonly contribute include iron deficiency, thyroid disorders, vitamin D deficiency, B12 deficiency, diabetes, sleep apnoea, coeliac disease, and chronic infections. Mental health conditions such as depression and anxiety are also common contributors.

Lifestyle and environmental factors can also play a role. Shift work, chronic sleep deprivation, inadequate nutrition, low physical activity, excessive alcohol or caffeine intake, and ongoing stress can all drive persistent fatigue. ME/CFS often follows a viral illness, and long COVID is a recognised cause of post-infectious fatigue.

Investigations and assessment

A structured assessment is important. Your GP will take a detailed history of your symptoms, sleep, mood, diet, alcohol and caffeine intake, medications, and any preceding infections or stressors. They will review any red-flag symptoms that may need urgent investigation.

Typical first-line blood tests may include a full blood count, iron studies, thyroid function, vitamin D, B12, kidney and liver function, and fasting glucose or HbA1c. Depending on your history, further tests such as inflammatory markers, coeliac screen, or morning cortisol may be considered. A sleep study may be appropriate where sleep apnoea is suspected.

If the initial assessment does not reveal an explanation, your GP will discuss next steps. In some cases, specialist referral (such as to sleep medicine, endocrinology, or rheumatology) may be appropriate.

Management and self-care strategies

Where a medical contributor is identified, treating that condition is often the priority. For example, replacing iron, correcting thyroid dysfunction, or treating depression may significantly improve fatigue over time.

For ME/CFS and long COVID, current guidance emphasises pacing, where activity is balanced against available energy to avoid post-exertional worsening. Supported self-management, sleep hygiene, gentle adjustment of activity where tolerated, and attention to mental health are important. Graded exercise programmes should be considered cautiously and individualised.

Good sleep routines, a balanced diet, hydration, and limiting alcohol and caffeine may support recovery. Your GP can discuss whether a Mental Health Treatment Plan or Chronic Disease Management Plan is appropriate to support access to allied health.